Intro to Pathology and Laboratory Medicine/Causes of Disease, Morbidity, and Mortality Flashcards
(101 cards)
1
Q
What are Pathologists?
A
Experts in disease. Their job is to work out what is making someone unwell, advise on their treatment, and stop other people from getting ill the same way
2
Q
What are the different forms of Clinical Pathology?
A
- Microbiology
- Clinical Chemistry
- Blood bank/Hematology
- Immunology
3
Q
What is Clinical Chemistry?
A
Form of clinical pathology that covers a bunch of different clinical and biochemical tests
4
Q
What is Microbiology?
A
Form of clinical pathology that looks at microorganisms, viruses, and bacteria
5
Q
What is Blood bank/Hematology?
A
Form of clinical pathology responsible for the blood products that are distributed in the hospital
6
Q
What are the possible tests to perform on blood? (6)
A
- Cell counts
- Electrolytes
- Proteins
- Markers of Inflammation
- Liver and kidney function tests
- Genetic test
7
Q
What are the possible tests to perform on urine? (5)
A
- Blood
- Leukocytes
- Protein
- Drugs
- Organisms
8
Q
What are the possible tests to perform on sputum?
A
- Culture
- Cytopathological examination
9
Q
What are the possible tests to perform on stool?
A
- Blood
- Ova
- Parasites
10
Q
What are the possible tests to perform on other body fluids?
A
- Culture
- Cytopathological examination
11
Q
What are the different forms of Anatomical Pathology?
A
- Surgical Pathology
- Cytopathology
- Forensic Pathology
- Molecular Pathology
12
Q
What is Surgical Pathology?
A
Form of anatomical pathology that looks at large tissue specimens and their architecture under a microscope for diagnoses
13
Q
What is Cytopathology?
A
Form of anatomical pathology that looks at individual cells, in the absence of architecture
14
Q
What is Forensic Pathology?
A
Form of anatomical pathology that specialize in forensics and perform autopsies including criminal suspicious cases
15
Q
What is Molecular Pathology?
A
Form of anatomical pathology that looks at the surgical inside of pathology
16
Q
What are the different types of samples in Cytopathology?
A
- Exfoliative
- Interventional
17
Q
What are the different types of Exfoliative Cytopathology Samples?
A
- Spontaneous: spontaneously produced by the patient; Pleural or peritoneal fluid, Sputum, and Urine
- Mechanical: intervention to scrape off cells from a patients mucus lining; Cervical pap smear, Bronchial brushings
18
Q
What is the specific type of Interventional Cytopathology Samples?
A
Fine needle aspiration: Where cells are sucked out to be looked at under the microscope; Lymph node, Thyroid
19
Q
What are the different types of Surgical Pathology?
A
- Gross (macroscopic) examination of organs and tissue; Biopsies, Surgical resections
- Histological (microscopic) examination
- Generation of a diagnostic pathology report
20
Q
What are the different Techniques in Pathology?
A
- Gross examination: examination of the specimen with the naked eye
- Microscopic examination
- Electron Microscopy: changes in organelles
- Ancillary tests
21
Q
What are the different types of Ancillary tests?
A
- Immunohistochemistry: testings for specific protein markers
- Special histochemical stains: to identify microorganisms
- Molecular pathology: looking at the genetic make up or the DNA of the tissue that we’re examining; chromosomal analysis, and DNA sequencing
22
Q
What type of stains give a purple and pink colouring?
A
Hematoxylin and Eosin Stains
23
Q
What are the components of a Pathology Report?
A
- Diagnoses
- Several factors that are important in patient staging in order to determine the patients next steps
24
Q
What is a Biopsy?
A
When tissue is removed from the body for examination
25
What are the different steps of Biopsy sample testing? (11 steps)
Step 1: the biopsy samples are booked in and prioritised
Step 2: larger, more complex samples, are dealt with by consultants
Step 3: smaller tissue samples like biopsies, are cut by scientists
Step 4: all the water content is removed from the tissue to make it rigid
Step 5: hot wax is poured over the tissue to embed and support it
Step 6: the wax block has the tissue in it and is cut into very thin slices
Step 7: the slices are put onto slides
Step 8: the slides are dyed to make them more visible under the microscope
Step 9: quality control - the scientists make sure the process so far is accurate
Step 10: the consultant looks at the sample and makes a diagnoses
Step 11: the GP reports back the results to the patient
26
What is Laboratory Medicine?
The discipline involved in the selection, provision and interpretation of diagnostic testing on samples from patients
27
What is Clinical Biochemistry?
The application of chemical, molecular and cellular concepts and techniques to the understanding and evaluation of human health disease; it is the provision of results of measurements and observations relevant to a disease or state of health
28
Why are Lab Tests requested? (10)
- Diagnosis of a disease
- Screening for a disease
- Determine severity of an illness
- Determine appropriate management
- Monitor progress of surgical recovery
- Therapeutic drug monitoring
- Identify drugs of abuse or poisonings
- Assessment of baseline or nutritional status
- Protection against legal repercussions
- Re-test to verify abnormal results
29
What are the main methods of collecting blood?
- Finger prick
- Venipuncture
30
What process should you be aware of when you draw blood?
Order of Draw
31
What is the Order of Draw?
The order in which you must draw blood to ensure you collect the proper specimen type in the correct tub and follow the correct order of draw
32
What is the sequence of the Order of Draw?
1. Light Blue
2. Red
3. Gold
4. Royal Blue (serum)
5. Green
6. Light Green
7. Royal Blue (K2 EDTA)
8. Lavender
9. Grey
33
What are Serums?
Blood samples that are collected
34
What are the different types of Serums?
1. Anti-coagulant
2. Serum Separation tube (sst)
35
What is an Anti-coagulant sample?
- Sample in a red top tube
- allowed to clot
- then centrifuged and separated from the cells
36
What is a Serum Separation Tube (SST)?
- Sample in a gold top tube
- provides a physical barrier between the serum cells after centrifugation
- allows for much better stability of analyte and allows for transport of a spun tube
37
What are the Green Topped Tubes?
- Blood samples (Plasma) that are collected with Heparin to prevent clotting
- Advantage: faster sample processing, and smaller sample volume
38
What are the Lavender Topped Tubes?
- Blood plasma collected with EDTA to preserve cellular elements of blood
- used for hematology tests such as CBC
39
What are Lavender Topped Tubes not good for?
- Divalent elements, such as Ca or Mg which are bound by EDTA
- Enzymes which require these ions as co-factors
40
What are the 8 different types of preanalytical phase testing errors?
- Incorrect Sample Type
- Ensue Correct Order of Draw
- Under-filled tubes
- Ensure tubes are mixed appropriately after collection
- Sample Hemolysis
- Extreme Temperature Exposure/Storage Conditions
- Delayed Transportation
- Time from Collection to Processing or Analysis
41
What is Accuracy?
The ability of data, measurements or results to match the actual 'true' value
42
What is Percision?
How close the data, measurements or results are to each other, working as a measure of the spread of data from the average
43
What is the Decision Thershold used for?
To rule in or rule out a disease
44
For a Non-Diseased population what does the Decision Thershold determine?
If a lab test is True Normal or False Positive
45
What is Specificity?
Term used to describe the absence of disease in a non-diseased population
46
How do you determine Specificity?
True normal/(True normal + False Positive)
47
For a Diseased population what does the Decision Thershold determine?
If a lab test is True Positive or False Negative
48
What is Sensitivity?
Term used to describe the power of the test which gives a positive result in diseased subjects
49
How do you determine Sensitivity
True Positive/(True Positive + False Negative)
50
What is Prevalence?
the precent of patients who have the disease that is being tested
51
What is the Receiver Operating Characteristic Curve?
A plot of the false positive rate (1-specificity) against the true positive rate (sensitivity)
52
What is Laboratory Stewardship?
The appropriate utilization of laboratory tests which encompasses correctly ordering, retrieving, and interpreting these tests
53
Why are up to 30% of tests and treatments unnecessary?
- No clinical value to patients
- Expose patients to potential
- Can lead to more testing to investigate false positive result
- Cause unwarranted stress for patients and families
- Consume precious time and resources
54
Why do unnecessary testings occur?
- Fear of lawsuit
- Practice habits are difficult to change
- Patient requests without evidence or knowledge or risks/benefits
- Lack of time for shared decision making
55
What are 5 things physicians and patients should questions?
1. Don't perform population based screening for 25-OH Vitamin D deficiency
2. Don't screen with pap smears until 21-69
3. Avoid routine preoperative laboratory testing for low risk surgeries without a clinical indication
4. Avoid standing orders for repeat complete blood count (CBC) on inpatients who are clinically and laboratory stable
5. Don't send urine specimens for culture on asymptomatic patients including the elderly, diabetics, or as a follow up to confirm effective treatment
56
How often do you need to get a Colonoscopy?
Typically every 5 years, starting at the age of 50
57
Why do people get Colonoscopies?
To check if they have cancer in their colon, and to remove it
58
Why would Colonoscopies be an unnecessary test to do?
- If cancer is found, as it is a slow growing cancer, once it is removed, the patient is clear for the next 5 years
- Causes diet restrictions and sedation
- Can cause heavy bleeding, tears in the colon, inflammation or infection, and severe abdominal pain
59
Why are doing Lab Tests before surgery considered unnecessary?
- usually aren't helpful as they rarely change the results in people who are low risk
- leads to more tests, which can delay surgery, cause false alarms and lead to anxiety
60
When should you get a PAP smear?
Between the ages of 21 and 69
61
What does a PAP smear do?
Tests the cells of the cervix
62
Why are doing PAP smears more than necessary considered to be unnecessary?
- cervical cancer is rare in those under 21 and over 69
- can be uncomfortable and cause bleeding
- may show something that is abnormal but will go away on its own cause anxiety
63
Why are doing Vitamin D tests considering to be unnecessary?
- most people have low vitamin d, so its not needed
- tests lead to more tests
64
Why are doing Self-Monitoring Blood Sugar for patients with Type 2 Diabetes considered to be unnecessary?
- offers little benefit because it does not improve their blood sugar control
- does not improve quality of life in a significant way
- self-monitoring can be stressful and cause anxiety
65
What is Morbidity?
Something that impairs the well-being or normal functioning of a patient
66
What is Mortality?
Something causing the death of a patient (death from disease)
67
What are the top 5 reasons for hospital stays in Canada?
1. Giving birth
2. COPD and Bronchitis
3. Heart attack
4. Heart failure
5. Osteoarthritis of the knee
68
True or False: Life expectancy has been steadily increasing in Canada?
True
69
What are the top 5 causes of death in Canada?
1. Malignant Neoplasms
2. Disease of heart
3. Accidents (unintentional injuries)
4. Cerebrovascular diseases
5. Chronic lower respiratory diseases
70
True or false: females are more likely to be diagnosed with cancer?
False. Males are
71
True or False: Females are more likely to survive cancer when compared to males
True
72
What is Pathology?
The study of the structural and functional changes in cells, tissues, and organs of the body that cause or are caused by disease
73
What is Disease?
Any deviation from, or interruption of the normal structure or function of a tissue, organ, or system
74
What does disease result from?
The disturbance to cells as a result of:
- physical insult
- environmental insult
- genetic aberration (inherited or acquired)
75
What is a Sign?
Clinical signs that can be objectively observed or measured by a physician or nurse
76
What are Symptoms?
Subjective complaints described by the patient
77
What is Etiology?
The study of the causes of disease (biological agents, chemical agents, physical factors)
78
What is Pathogenesis?
The mechanism of disease. The events that occur after the contact with the etiologic agent until the expression of disease
79
What are Pathological and Morphological Manifestations?
Changes in structure and function of tissues, organs and systems
80
What are Complications and Sequelae?
Secondary consequences of a disease
81
What is Prognosis?
Anticipated course of the disease and final outcome
82
What is Epidemiology?
The study of the distribution and determinants of health related states, including disease incidence and prevalence
83
What is Incidence?
Number of new cases arising in a population over a given time period
84
What is Prevalence?
Total number of cases of the disease in a given population
85
What does Congenital disease mean?
Present at birth
86
What are Congenital Anomalies?
Structural or Functional deficits that occur in utero and are present at birth
87
What is a Malformation genetic factor?
Intrinsically abnormal development process that can involve single or multiple organs in the body
88
What is a Disruption genetic factor?
- secondary destruction of an organ or body region that was normal in development
- extrinsic disturbance
89
What is a Deformation genetic factor?
Secondary or extrinsic destruction of the normal development process
90
What are some examples of malformation genetic factors?
- polydactyly
- spina bifida
- congenital heart disease
91
What is an example of a disruption genetic factor?
Amniotic band causing digit amputation
92
What is an example of a deformation genetic factor?
Clubbed feet
93
What is a Teratogen genetic factor?
Environmental factors causing abnormal development or congenital anomalies
94
What is an example of a teratogen genetic factor?
Fetal Alcohol Syndrome
95
What are the different disease classifications based on Pathogenesis? (9) VITAMIN CDE
- Injury
- Inflammation
- Infection
- Immunological Reaction
- Neoplasia
- Metabolic or Endocrine
- Nutritional
- Vascular
- Psychological Factors
96
What does Idiopathic mean?
- unknown etiology
- currently no known cause
- causes may emerge through further investigation
97
What does Iatrogenic mean?
Disease or any adverse condition resulting from treatment by a health care professional
98
What are adverse events could occur due to an Iatrogenic disease?
Unintended injury or complication resulting in death, disability or prolonged hospital stay
99
What are adverse drug events that could occur to an Iatrogenic disease?
- wrong medication
- wrong dose
- harmful drug interaction
100
What are some adverse surgical events that could occur to an Iatrogenic disease?
- wrong procedure
- sponges left in patient following surgery
101
What are some adverse events that can occur while being hospitalized?
- development of bed sores in immobile patients
- hospital acquired or nosocomial infections
